Mental health-related quality of life in caregivers of patients with acquired brain injury: the central role of depressive symptoms

Abstract

Objective: To assess health-related quality of life and psychological symptoms in family caregivers of patients with severe chronic acquired brain injury, and to determine the independent contribution of prolonged grief to mental health-related quality of life beyond depressive and anxiety symptoms. Methods: In this cross-sectional study, 50 primary family caregivers completed standardized measures of depression (BDI-II), anxiety (BAI), prolonged grief (PG-12), and healthrelated quality of life (SF-12). Associations between variables were analysed using Pearson correlations and hierarchical multiple linear regression. Results: Forty-eight percent of caregivers presented clinically significant depressive symptoms, 26% clinically significant anxiety symptoms, and 34% met criteria for prolonged grief. Mental health-related quality of life was markedly reduced (MCS = 39.86; SD = 10.08), whereas physical health-related quality of life remained within normative ranges (PCS = 51.21; SD = 8.52). Depressive symptoms, anxiety symptoms, and prolonged grief were negatively associated with mental health-related quality of life, with depression showing the strongest correlation (r = −0.709; p < 0.001). In the regression models, only depressive symptoms independently predicted mental health-related quality of life (β = −0.649; p < 0.001), explaining 52.5% of the variance (R² = 0.525), whereas anxiety and prolonged grief did not show independent effects. Conclusions: Caregivers experience high levels of psychological distress and significantly impaired mental health-related quality of life, with depressive symptoms representing the main factor associated with this impairment, highlighting the importance of their systematic detection and targeted intervention in long-term care settings for patients with severe acquired brain injury.